Racial Disparities in U.S. Health Care

March 13 -- Many have long suspected that black Americans face life-threatening inequalities in their health care. Now a raft of clinical studies is providing solid evidence that the suspicion is true.

A new study, published this week in the Journal of the American Medical Association, found blacks are significantly less likely than whites to benefit from health- and survival-enhancing interventions.

The study was based on data collected on four clinical services used to measure quality of care among people on Medicare in 1997 — the frequency of women's breast cancer screenings, eye exams for patients with diabetes, use of beta-blockers after a heart attack, and follow-up after hospitalization for mental illness.

Blacks were less likely that whites to receive all four services.

The new study is the latest of many that have found racial differences in everything from flu shots to kidney transplants. Additional research published this week in the journal Cancer, for instance, finds that black women with ovarian cancer have a 30 percent increased risk of death and are 40 percent less likely to have surgery than white women.

And further unsettling data from the Commonwealth Fund 2001 Health Care Quality Survey found that 15 percent of blacks feel they would receive better care if they were of a different race or ethnicity.

Reason for Inequality Is Less Clear

The root causes of these inequalities are less clear, admit experts, and there are likely to be many, such as poor access to good health care or insurance, a lack of understanding of the scope of inequality by physicians or the unwitting biases held by doctors treating minority patients.

"When you think about what could be contributing to these disparities, there could be a whole number of things from the patient perspective, the [physician's] perspective and the health-care plan's perspective," says Dr. Lisa Cooper, associate professor of medicine and health policy and management at Johns Hopkins University in Baltimore.